Why the study?
Central aortic blood pressures and arterial stiffness better predict cardiovascular outcomes than brachial pressures, but their response to renal denervation in stage 3 and 4 chronic kidney disease had not been examined.
Does renal denervation improve central blood pressures and arterial stiffness in patients with Stage 3 or Stage 4 CKD and resistant hypertension?
Population
About 25 consecutive patients with Stage 3 or Stage 4 CKD and resistant hypertension
Comparison
Renal denervation with pre- vs post-procedure evaluation
Design
Single-center, single-arm study
Follow-up
2-year follow-up period
Key result
Renal denervation in patients with Stage 3 or 4 CKD and resistant hypertension did not significantly reduce median central blood pressure at 6 months (127/75 to 118/70 mm Hg; P=0.13).
Authors
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Renal denervation should not yet target central BP in Stage 3-4 CKD; leaves open office BP effects and outcome trials.
Does renal denervation improve central blood pressures and arterial stiffness in patients with Stage 3 or Stage 4 CKD and resistant hypertension?
p-value: p=.13
In patients with Stage 3-4 CKD and resistant hypertension, renal denervation significantly improved office blood pressures up to 24 months, but did not significantly change central blood pressures, 24-hour ambulatory pressures, or pulse wave velocity.
Prasad et al. (2019) studied Stage 3 and Stage 4 chronic kidney disease (CKD) and resistant hypertension (n=25). Renal denervation (RDN) vs. Baseline was evaluated on Change in central blood pressures (CBP) from baseline to 6 months post-RDN (p=.13). Renal denervation in patients with Stage 3 or 4 CKD and resistant hypertension did not significantly reduce median central blood pressure at 6 months (127/75 to 118/70 mm Hg; P=0.13).
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